Lawrence Bruce Godwin, M.AC. L.AC.

Individual provider Active NPI Acupuncturist · Bigfork, MT

NPI 1750021150 · NPPES record last updated Apr 1, 2022

Key facts

NPI
1750021150
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
MED-ACU-LIC-37875 (MT)
Practice address
8000 Hwy 35, Suite 4
Bigfork, MT 59911
Phone
(571) 239-1728
NPI assigned
Apr 1, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MED-ACU-LIC-37875MTMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist
Group: 193400000X SINGLE SPECIALTY GROUP
171100000X MED-ACU-LIC-37875 MT Yes

Addresses

Primary practice location

8000 Hwy 35, Suite 4
Bigfork, MT 59911

Mailing address

PO Box 1548
Bigfork, MT 59911-1548
Phone (571) 239-1727

Other providers in Bigfork, MT

All providers in Bigfork, MT · Acupuncturist in Montana

Sources for this page

Verify at the official NPI Registry.